It’s here again. The dreaded date on the calendar. Every six months or so, my phone reminds me of this appointment. And the closer it gets, the more tense and fearful I get. Counting the days, preparing mentally and physically.
But I am never really ready.
The day of the actual procedure is always a day of gut-wrenching fear and other mixed feelings. The procedure is a routine screening CT scan to check on my cancer (is it there? did it return? what else might be brewing?), and the feeling is called “scanxiety” (or, for non-patients, scan anxiety)
Anxiety, including that related to cancer scans, is part of how your body responds to threats. It releases adrenaline and other hormones that prepare you for “fight or flight.” This can make you nauseated or trouble your sleep in the days before the procedure or while you wait for the results.WebMD
I was diagnosed in 2014, and the last time I had any detectable cancer in my body was almost five years ago. Initially, I was scanned once every three months, then every four to five months and the last two were six-seven months apart. If I “pass” this next one, I might graduate to one per year.
Will I ever stop needing them? Not sure. That is up to the doctors. I’d love to stop getting scanned with the massive dose of radiation each time.
Every CT scan for the chest gives 7 mSv per dose which is equivalent to 2 years of naturally occurring radiation, every abdomen and pelvis scan’s dose is 20 mSv which is equivalent to 7 years of natural radiation (data from Radiology Info)
That is scary and adds to scanxiety. I am worried not only about the results of the cancer screening but also about the potential long-term effects of that screening that might lead to another cancer down the road (due to these high levels of radiation).
On the other hand, I don’t want to NOT know in case something is brewing again.
My original tumor was growing for many years and I had zero symptoms to make me realize it and to catch the beast at an earlier stage. So, it’s a conundrum.
What is Scanxiety?
Cancer is a bitch. It takes over your entire life.
When it is still inside you, especially in the beginning, there is almost nothing else you are able to think about.
With time, this preoccupation might lessen.
At this point, the cancer does not rule my life by any means.
I’ve been so much luckier than others. I won a lottery ticket, even though I was given 10% chance of 5-year survival.
Time heals the wounds. The initial trauma from the first year of my cancer journey is probably somewhere in the recesses of my mind.
Worry and other emotions come hand in hand with cancer and survivorship.
Still, I don’t think about cancer every single minute of my day. That’s a definite improvement.
Occasionally, I’ll remind myself that one thing is good and another is not so good to keep cancer at bay. Choosing food, cosmetics, or physical activity are these moments when the thought of cancer does pop up.
But the clearest reminder of the cancer are these dreaded CT scan days.
One of the most devilish characteristics of cancer as opposed to different illnesses is its unpredictability.
Even the doctors that treat me, will rarely know what might be happening within my body. They can assume based on statistics, sure, but I am not a statistic.
Even if my type and stage of cancer might have had a particular survivability rate, it means that there is a great variability in outcomes still.
Anxiety often comes when people have to face things they can’t control. For someone who has — or has had — cancer, a common fear is that their body will betray them, or that cancer will eventually overcome them.Karen Fasciano, PsyD
I am reminded of this unpredictability of cancer when it is time for a scan.
I become irritable, I find myself ruminating on topics of mortality and legacy, and I become a bit more weepy and clingy.
I have more troubles sleeping as the scary thoughts start invading my mind and won’t let me get some shuteye.
For a few days before the ct scan, my palms get sweaty, my throat tightens, and I get a general jittery feeling.
And this is only the first part of it. I call it pre-scanxiety.
What comes after, is even worse: waiting for the results after the scan is completed. Other patients mention also that waiting for the results can be even more nerve-wracking than the time before the scan.
Waiting for the results of any scan that will tell you if the cancer is active and taking up residence in new parts of your body is just as anxiety-inducing, if not worse, as the time leading up to and the day of the actual scan.Susan Rahn
Once the technician completes the scan, it is then read by the radiologist and sent over to the oncologist.
Now, my oncologist rarely calls me to give me results.
Most often, we have an appointment to go over the scan about a week after the actual procedure. An entire week of waiting!
This is when the scanxiety is really kicking in and getting worse the closer I get to hear the news.
How I Try to Deal with CT Scan Anxiety?
There are some ways to deal with scanxiety, some of them very helpful, others less so in my opinion.
The magazine Cure offers 10 ideas for coping with scanxiety ranging from meditation to medication, acknowledgment of the feelings to pretending the positive results have already arrived.
I guess, everyone copes in their unique ways.
Scanxiety, points out Katz Ressler, can be intense and may mimic symptoms of Post-traumatic stress disorder (PTSD).
PTSD is an extreme anxiety disorder that can occur in the aftermath of a traumatic or life-threatening event.
Symptoms of PTSD include re-experiencing the trauma through intrusive distressing recollections of the event, flashbacks, and nightmares.Powerful Patients
Here is what I found helpful for me.
1. Having a clear idea of the timeline for the scan and the results.
In the early days of my cancer scans, I would just wait for the oncologist to call and either deliver the news or make an appointment for a visit. This was extremely nerve-wracking. Since then, I make sure to have a good plan.
- How will I get the results? (a visit or a phone call)
- Who will be calling? (my oncologist or the nurse)
- If I am going to have a visit, should I be bringing someone with me for emotional support?
Timing is also important for one additional reason. I researched extensively how to minimize the harmful long-term effects of excessive radiation exposure.
As soon as I complete my pre-scan blood work – one week prior to the scheduled scan – I start eating kiwi fruit in massive amounts. Kiwis are very rich in potassium, magnesium, calcium, and minerals which may protect against cesium radiation and help the body rebuild the damaged DNA.
With just one kiwi a day, subjects were able to reduce damage to the DNA in their blood by 60 percent.
And the ones who had three kiwis a day didn’t just protect the DNA, they helped the DNA build itself up by 60 percent.
There are multiple bioactive compounds in kiwi: vitamin C, chlorogenic acid, quinic acid.Everyday Health
Another pre-scan must is drinking tomato juice for a few days prior to the procedure.
While there might not be a clear link established yet, several studies suggest that tomato juice has at least some DNA-protective properties.
Tomato juice consumption may suppress human lymphocyte DNA damage caused by radiation, but further examination is required.Possible benefits of tomato juice consumption: a pilot study on irradiated human lymphocytes from healthy donors
2. Stay in the Now
Scanxiety is not about what’s happening in the present. It is all about the future. What will they find, if anything? What will this mean for me and my family? How will it impact any plans for the future?
I find that focusing on the present moment is very helpful in dealing with anxiety. You will say, easier said than done.
Of course, I cannot just magically stop thinking, but I find it helpful to do something I care about deeply and hopefully it will take the mind off the thoughts about the future.
I started gardening a few years ago and focusing on my garden chores is very helpful.
Playing with my son or our cat can also be a wonderful distraction. We play cards or board games or laugh at the cat chasing after the laser beam. It does the trick, even if only for a short while.
More structured activities to stay in the moment include breathing exercises, guided visualization, or a chakra meditation.
For me personally, however, the best way to stay in the moment is vigorous exercise.
Jumping on my spin bike and cranking up the music for 30-40 minutes takes me in an instant into the here and now.
I am a truly avid exerciser for a few weeks around my scans. I wish I’d be as motivated all year round!
Ultimately, to change the mindset, the only thing that really works is to get distracted.
This is why I find the times when I work generally better for scheduling scans than the times I am off teaching. When I am busy with a task, I am able to forget what’s coming, or rather, what I am anticipating might be coming.
Short of getting busy with work, I find that watching my favorite movie or binging on a Netflix series can make a huge difference.
Even better are the stand-up comics (George Carlin and Robin Williams, you are my saviors!). A good laugh can definitely take my mind off even the worst anticipated outcome.
3. Finding support
My family is my rock. It is for them that I want to beat this cancer, and it is also the fear of not being around for them that makes the scanxiety so much worse. Holy irony!
Still, I do not want to overburden my loved ones with my fears. They know very well what is at stake, and especially with young children in the house, I want to spare them the feelings of dread and anxiety that I am experiencing.
Also, although they are very sympathetic listeners, they still did not go through what I am going through and so, they cannot completely relate to my feelings.
I found online support groups for cancer patients to be a great source of information, motivation, and encouragement.
The people on these forums understand very well what we are all going through – we all are carrying our crosses, all a bit different from one another, but also all with common features such as scanxiety.
4. Supplements to cope
In cases of extreme anxiety, there is no shame in getting medication for it or to seek the support of a psychiatric medical team.
My anxiety is in bounds so I find natural supplements working fine for now. Here are two that were the most helpful.
Holy Basil Tincture
Holy Basil or Tulsi is an herb used for a variety of ailments in Ayurvedic medicine.
Holy basil is an adaptogen with strong anti-inflammatory and antioxidant properties. It helps to ease inflammation and pain, and it also can relieve anxiety.
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You can buy a ready-made tincture from a trusted purveyor like the one below. Or, you can make it at home. It is very easy to make and it takes only two ingredients: the herb and strong alcohol.
It is ok to use fresh herbs or dried. I choose to use dried herbs.
- Get a quart-size glass jar with a top.
- Put dried leaves in the jar, halfway to ¾ way up.
- Add enough alcohol (not stronger than 70% alc/vol – 140-proof) to cover up all the leaves.
- Seal the jar tightly and keep infusing for minimum of 2 weeks up to 1 month.
- Store in a dark, cool place, and shake once a day.
- After that time strain and store the finished tincture in a dark jar or bottle.
I like to move the tincture into a dark-glass bottle with a dropper for the ease of dosing.
Use one dropper-full once or twice a day.
I buy my Holy Basil dry herb from Mountian Rose Herbs. All their herbs are of amazing quality and purity. The company is not only a trusted purveyor of world-class herbs, essential oils, and teas, but it also has a great ethical stance.
CBD Oil or Tincture
I tried CBD for Anxiety and it does work! One dropper-full of a full-spectrum CBD oil takes the edge off. I take my oil under the tongue for 30 seconds or so to improve and to speed up absorption.
I personally don’t love the sensation of swallowing oil, so I chase it with another drink. In about 15 minutes I feel calmer, more centered, and am able to breathe better.
Check out these two options: both are organic, and you can choose either CBD oil or CBD soft gels.
The Day of My Scan
My scan is scheduled for 10 AM. I have to start drinking the contrast two hours ahead, so I need to be at the hospital around 8 AM. This is good.
That means, I get up, dress in some loose-fitting clothes that have zero metal in them (this way I don’t need to dress into a hospital gown), and get going.
My nine-year-old is up and cheerful as ever.
“Where are you going, Mommy?” “I have to go to the doctor to get that checkup to make sure that cancer has not come back. Remember? We talked about it yesterday.” “I know. Good luck mommy. It will be ok.”
He’s already absorbed in his TV show. Life goes on.
I eat my last two kiwis and take a dropper-full of my CBD oil and Holy Basic Tincture. I grab my bottle filled with tomato juice. I give my boy a kiss on the forehead, get a whiff of his smell – kid’s hair, sweat, and cinnamon-swirl toast he had for breakfast – and I’m out the door.
In the car, I play super loud music: David Bowie’s Heroes, Queen’s We Are The Champions, Gloria Gaynor’s I will Survive. Cheesy? Maybe, but it does the trick. I am distracted and manage not to cause an accident on the way to my scan.
In the waiting room, there are others.
Some are drinking the “ambrosia” – a truly disgusting contrast drink.
The TV is blaring on whatever channel a staff member puts on, with disregard for the needs or preferences of the patients.
I sense butterflies in my stomach and feel like I have to run to the bathroom every five minutes. My breathing is a bit shallow and uneven. But I feel the calm from my tinctures coming over me. I relax a bit.
I switch up between drinking the contrast and my tomato juice. I realize that it’s quite possible that I am doing all this just so that I can feel more in control.
At least eating the kiwis and drinking my tomato juice is my own decision, the only I get to make in this process.
Finally, I get called into the scan room. The technician is professional and nice. The scan takes less than 10 minutes to be completed. Nothing to it really.
When it is over, I find myself looking into the technician’s eyes and trying to discern something from his behavior and the way he treats me.
Why is he so nice? Did he see something and now feels sorry for me?
I am sure he did. Otherwise, why would he be giving me all this special attention, helping me get off the scan table with special care?
I try to ask, “How are we doing? All good on that screen?”.
But he cannot tell me anything. Either he doesn’t know how to read the scan pictures or, he’s not allowed to say anything. So, this attempt fails. I will have to wait for the entire week to hear the results.
But at least one part is over…. until the next scan.